@article{Han_Cao_Qin_Wei_Ruan_Cao_He_2020, title={Morbid obesity is adversely associated with perioperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy}, volume={14}, url={https://cuaj.ca/index.php/journal/article/view/6389}, DOI={10.5489/cuaj.6389}, abstractNote={<p><strong>Introduction:</strong> Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP.</p> <p><strong>Methods:</strong> Hospitalized patients who underwent RALRP from 2008– 2014 were identified using the National Inpatient Sample database. We grouped RALRP patients into non-obese, obesity class I–II, and obesity class III (morbid obesity). Rates of blood transfusion, intraoperative and postoperative complications, in-hospital mortality, prolonged length of stay, and total costs were compared among the three groups by univariate regression, multivariate regression, and propensity score weighting analysis.</p> <p><strong>Results:</strong> Of 53 301 patients identified, 48 725 were non-obese, 3572 were diagnosed with obesity class I–II, and 1004 were diagnosed with morbid obesity. Compared to non-obesity (7.62%), overall postoperative complications were commonly observed in obesity class I–II (10.55%) and morbid obesity (17.11%). Multivariable analyses suggested that morbid obesity was associated with increased overall postoperative (odds ratio [OR] 2.00, 95% confidence interval [CI] 1.65–2.42), cardiac (OR 1.63, 95% CI 1.03–2.58), respiratory (OR 4.03, 95% CI 3.04–5.36), genitourinary (OR 1.77, 95% CI 1.08–2.90), miscellaneous medical (OR 1.94, 95% CI 1.58–2.39) complications, prolonged hospitalization (OR 1.86, 95% CI 1.57–2.21), and 12% higher total cost. Propensity score weighting analysis yielded similar results. Adequate covariate balance was achieved for all variables after weighting.</p> <p><strong>Conclusions:</strong> Morbid obesity is adversely associated with perioperative outcomes in RALRP. Close management is required in patients undergoing RALRP with morbid obesity for potential worse prognosis.</p>}, number={11}, journal={Canadian Urological Association Journal}, author={Han, Hedong and Cao, Zhexu and Qin, Yingyi and Wei, Xin and Ruan, Yiming and Cao, Yang and He, Jia}, year={2020}, month={Jun.}, pages={E574–81} }